Thirty years of retinoblastoma (1960-89): changing patterns of incidence

Retinoblastoma in the United States: A 40-Year Incidence and Survival Analysis

PURPOSE

To determine the incidence of retinoblastoma in the United States from 1973 to 2012 (40 years) and characterize the 5-year overall survival rate of the included patients.

METHODS

Cases of retinoblastoma were derived from the Surveillance, Epidemiology, and End Results (SEER) Program (National Cancer Institute, Rockville, MD). Incidence rates were calculated using U.S. Census Bureau data as the standard population, and trends over time were determined using the chi-square test. Hazard ratios with a 95% confidence interval (CI) were estimated for variables associated with mortality using Cox regression models. Survival rates were calculated using the Kaplan-Meier method and compared among different clinical and demographic categories.

RESULTS

A total of 879 cases of retinoblastoma were derived from the SEER databases. The annual incidence rates of retinoblastoma for a period of 40 years were 12.14 (95% CI: 11.32 to 12.96) cases per 1 million children 4 years or younger and 0.49 (95% CI: 0.36 to 0.65) cases per 1 million children between the ages of 5 and 9 years. There was no significant trend for children 4 years or younger (P = .6324) or between the ages of 5 and 9 years (P = .7695). The 5-year overall survival rates were 97.6%, 92.7%, 91.1%, and 96.4% for children diagnosed at the first, second, third, and after the third year of life, respectively (P = .0136). The 5-year overall survival rates were 92.5% for bilateral and 96.3% for unilateral cases (P = .0116). The 5-year overall survival rates were 90.8%, 92.5%, 97.6%, 97.3% for increasing time intervals (1973 to 1979, 1980 to 1989, 1990 to 1999, and 2000 to 2012, respectively; P = .0017).

CONCLUSIONS

The incidence rate of retinoblastoma in the United States has remained stable for the past 40 years. Survival rate analysis indicates a significant effect of laterality of tumor, age at diagnosis, and decade of diagnosis. [J Pediatr Ophthalmol Strabismus. 2018;55(3):182-188.].

A 12-year epidemiological review of retinoblastoma in Omani children

AIM

To describe the epidemiology of retinoblastoma (RB) in Omani children.

METHOD

The National Cancer Registry, hospital records, and treatment abroad registers were reviewed to identify the characteristics of Omani children diagnosed with RB between 1990 and 2002.

RESULTS

Twenty-nine children (12 male and 17 female) were diagnosed with RB. The age-adjusted incidence was 4.04/million/year in children < 15 years and 8.33/million/year in children < 5 years. The mean age at diagnosis was 32.2 months (33.8 months for unilateral RB and 13.2 months for bilateral RB). 75% had unilateral tumors and 25% had bilateral tumors. The five-year survival rate for RB was 89%. None of the patients had a family history of RB.

CONCLUSION

The incidence of RB in Oman is at par with other countries. A definite female preponderance exists in the Omani population. The proportion of unilateral RB cases is unusually high among Omani children. The five-year survival rate is almost at par with that reported in the West. Genetic studies and further longitudinal studies of surviving RB cases could further enhance the knowledge of the epidemiology of RB in Oman.

Survival for retinoblastoma in Europe

The survival of 954 cases of retinoblastoma, diagnosed between 1978 and 1989 in 28 populations belonging to 17 European countries and covered by cancer registration, is analysed in this study. Data were collected in the framework of the EUROCARE study following a common protocol and data-check procedures and were analysed centrally by the Kaplan-Meier method and by the Cox regression model. Overall 5-year survival in the European pool was 93% (95% confidence interval (CI): 91--95%), for both sexes. Five-, 10- and 18-year survival for a subset of 235 patients diagnosed in 1978--1981 was 91, 89 and 86%, respectively. Children diagnosed in their first year of age had a slightly higher survival (94%) than those diagnosed subsequently (92%). Survival rates lower than the European average were found in the Eastern European countries, Italy, England and Wales, Scotland, Spain and Denmark. Higher survival was found in the other Nordic countries and in Central European countries. However, none of these differences was statistically significant. There was statistically significant effect related to the period of diagnosis, with a 50% reduction in the relative risk (RR) for children diagnosed in 1986--1989 compared with those diagnosed in 1978-1981.

Incidence and survival characteristics of retinoblastoma in Singapore from 1968-1995

PURPOSE

To describe the incidence and survival of 69 Singapore residents with retinoblastoma in all Singapore hospitals from 1968-1995.

METHODS

Data of all Singapore residents diagnosed with retinoblastoma from 1968-1995 were collected by the Singapore Cancer Registry based on notifications from physicians, pathology records, hospital discharge records, and death certificates. The medical records of 46 patients were traced, and information on laterality of tumor, spread of tumor, mode of treatment, and family history of retinoblastoma was obtained. Time trends and survival characteristics of the cohort were described.

RESULTS

The incidence rate of retinoblastoma was 2.4 per 1 million for children <9 years and 11.1 per 1 million for children <5 years. The incidence of retinoblastoma has been almost uniform over time from 1968-1995, except for an apparent increase in 1988-1992. The 3-year survival rate for retinoblastoma was 83%. Survival rates were higher in children <2 years because children who present at a younger age may have tumors diagnosed at earlier stages of the disease. There was no difference in survival rates for sex, race, laterality, family history of retinoblastoma, treatment, or year of diagnosis.

CONCLUSION

Retinoblastoma is the most common eye cancer in children that may cause blindness or death. The incidence rates of retinoblastoma in Singapore have remained fairly stable over 28 years, and the survival rate is higher in younger children. This study will be helpful in monitoring future disease patterns in Asian populations.

Incidence and survival of retinoblastoma in The Netherlands: a register based study 1862-1995

AIM

The aim of this study was to determine the (time trends in) incidence and survival of hereditary (familial and sporadic) and non-hereditary retinoblastoma for male and female patients born in the Netherlands between 1862 and 1995.

METHOD

The national retinoblastoma register was updated and now consists of 955 patients. The missing dates of death were obtained from the municipal registers and the Central Bureau of Genealogy in The Hague. Mortality was compared with the Dutch vital statistics.

RESULTS

From 1862 to 1995 no significant differences in incidence for retinoblastoma were found in the hereditary subgroups. Further, no significant differences between males and females were found, both overall and in the hereditary subgroups. The average incidence of retinoblastoma increased until 1944, probably due to incompleteness of the register, and stabilised after 1945 (1 per 17000 live births). From 1900 to 1995 the standardised mortality ratio increased for hereditary retinoblastoma patients from 2.9 to 9.0 and decreased for non-hereditary retinoblastoma patients from 1.9 to 1.0.

CONCLUSION

Although survival for retinoblastoma was significantly better after 1945 than before, in comparison with the Dutch population the mortality between 1900 and 1990 increased for the hereditary and decreased for the non-hereditary retinoblastoma patients.

Trilateral retinoblastoma. A report of five patients

BACKGROUND

Trilateral retinoblastoma is a well recognized, although rare, syndrome. Most of the reported cases have involved a family history of retinoblastoma (RB) and the disease is almost always fatal. The authors chose to investigate the cases of trilateral retinoblastoma occurring in the West Midlands, a region of the United Kingdom with an increasing incidence of bilateral sporadic RB.

METHODS

Five patients with trilateral retinoblastoma (including two were previously reported), diagnosed in 146 consecutive patients with RB in the West Midlands Health Authority Region between 1957 and 1994, are presented (an incidence of 3%). Their clinical presentation, treatment, and outcome are described.

RESULTS

There were 4 patients with pineoblastoma, only one of whom had a positive family history. The mean age at diagnosis of RB and 6 months, whereas the patients with pineoblastoma were diagnosed at a mean age of 2 years 8 months. The tumors were not evident on the initial computed tomography scans. One child presented with a calcified suprasellar mass 13 months before the bilateral sporadic RB was identified. Death occurred within 1 month of diagnosis of the intracranial tumor in 3 patients who did not receive any treatment. In the other 2 patients who were treated, death occurred at 15 months and 2 years 7 months, respectively, after diagnosis of intracranial tumor.

CONCLUSIONS

Early diagnosis with regular neuro-imaging and more aggressive treatment may improve prognosis in patients with RB and an intracranial tumor.